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Month: February 2009

Overweight and obesity among children is widely regarded as being even more serious than it is among adults, with a very rapid rise in prevalence in the last two decades. Child obesity is likely to continue into adulthood, and many of the problems linked to obesity are more severe if the obesity has been present for a long period. Adults with the highest risk of diabetes, cardiovascular disorders, liver malfunction and orthopaedic dysfunction, are likely to have the most extreme levels of obesity and to have been obese since childhood[i].

Projections of child obesity based on trends from the 1980s and 1990s indicate that the annual increase in child obesity prevalence is itself increasing[ii]. By the year 2010, some 26 million school children in the EU are expected to be overweight, of which 6 million will be obese. The numbers of overweight children will rise by some 1.3 million per year, of which the numbers of obese children will rise by over 0.3 million per year.

At a conservative estimate, over a million obese children in the EU are likely to show a range of indicators for cardiovascular disease, including high blood pressure and raised blood cholesterol levels, and to have three or more indicators of the metabolic syndrome[iii]. Over 1.4 million children could have early stages of liver disorder.

The costs of childhood obesity have not been estimated but should include lost educational opportunity. A study of children’s quality of life found the psychological effects of severe obesity to be equivalent to a diagnosis of cancer[iv].

Behaviour, learning and mental health problems in children are rising as fast as rates of obesity and diabetes. Food affects brains as well as bodies, and early malnourishment can have devastating effects on both. Conversely, improving nutrition can help reduce antisocial behaviour as well as symptoms of ADHD, dyslexia, depression and related conditions[v].

The only pan-European estimates of children’s food consumption patterns are from self-reported surveys of health behaviours of children aged 11-15 years[vi]. The most recent (for 2001-2002) found:

In virtually all countries fewer than 50 per cent of children ate vegetables every day. On average, 30 per cent of children said they ate vegetables daily, but the children in countries once famous for their Mediterranean diets reported lower than average levels, especially Spain, where vegetables were typically eaten daily by only 12 per cent of children.

In virtually all countries fewer than 50 per cent of children ate fruit every day. On average, 30 per cent of boys and 37 per cent of girls reported eating fruit daily, but in sixteen countries only 25 per cent of children were eating fruit more than once a week. Lowest levels of consumption were reported among children in Northern European countries.

Soft drinks and confectionery were consumed daily by about 30 per cent of children (over 40 per cent in some countries).

According to the last National Diet and Nutrition Survey in the UK[vii]:

92 per cent of children consume more saturated fat than is recommended

86 per cent consume too much sugar

72 per cent consume too much salt

96 per cent do not consume enough fruit and vegetables

Governments are trying to improve children’s diets, but young people’s exposure to marketing pressures in our time-poor, anxiety-ridden, media-driven society is at an all-time high.

Widespread action is needed to reverse current trends – and we all need to take responsibility for what we are feeding young bodies and minds.

The class involves 100% hands-on practical cooking in a small, supervised group, combined with teaching of up-to-date information and research findings on the effects of diet on health. Clear, easy-to-follow presentations and handouts are provided with plenty of opportunity for questions and discussion.

A new global policy report estimates that approximately 45 percent of colon cancer cases and 38 percent of breast cancer cases in the US are preventable through diet, physical activity and weight maintenance. The report also sets out recommendations for policies to reduce the global number of cancer cases.

The overall message of the report, Policy and Action for Cancer Prevention, published yesterday by the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR), is that all sections of society need to make public health, and cancer prevention in particular, a higher priority.

It includes estimates on the proportion of many different types of cancer that could be prevented through diet, physical activity and weight management. In the UK, akmost 40 per cent of the most common cancers could be prevented. That figure does not include smoking, which alone accounts for about a third of cancers.

Percentage of cancers that could be prevented via healthy diet, healthy weight and physical activity

US

UK

Brazil

China

Endometrium
(lining of the uterus)

70

56

52

34

Esophagus

69

75

60

44

Mouth, pharynx & larynx

63

67

63

44

Stomach

47

45

41

33

Colon

45

43

37

17

Pancreas

39

41

34

14

Breast

38

42

28

20

Lung

36

33

36

38

Kidney

24

19

13

8

Gallbladder

21

16

10

6

Liver

15

17

6

6

Prostate

11

20

n/a

n/a

These 12 cancers combined

34

39

30

27

Different Policy Recommendations For Different Groups

As part of the evidence-based report, thought to be the most comprehensive ever published on the subject, two independent teams of scientists systematically examined the evidence for how policy changes can influence the behaviours that affect cancer risk. Following this, a panel of 23 world-renowned experts made a total of 48 recommendations, divided between nine different but often overlapping sectors of society – called “actor groups” in the report. These actor groups are: multinational bodies; civil society organizations; government; industry; media; schools; workplaces and institutions; health and other professionals; and people.

Schools, workplaces and institutions should not have unhealthy foods available in vending machines.

Health professionals should take a lead in giving the public information about public health, including cancer prevention.

People should use independent nutrition guides and food labels to make sure the food they buy for their family is healthy.

Professor Sir Michael Marmot, Chair of the WCRF/AICR Panel, said,

When people think of policy reports, they often think they only speak to governments. But the evidence shows that when it comes to cancer prevention, all groups in society have a vital role to play.

Panel member Tim Byers, MD, MPH of the University of Colorado Denver said,

Estimating cancer preventability is a very complex prospect that involves making a number of assumptions. Having said that, the figures in this report are as good an estimate it is possible to achieve about the proportion of cancer cases that could be prevented through healthy diet, regular physical activity and maintaining a healthy weight. On a global level every year, there are millions of cancer cases that could have been prevented. This is why we need to act now before the situation gets even worse.

The report also includes preventability estimates for the UK (which, like the US, is considered a high-income country), as well as for China and Brazil, which respectively represent low and middle-income countries.

Policy Report Represents the Next Step

The new WCRF/AICR Policy Report is a companion document to the expert report Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective, which was published by AICR and WCRF in November of 2007. That expert report evaluated the scientific evidence from over 7000 studies and came away with 10 recommendations for lowering cancer risk.

The 2007 expert report identified the specific choices that people can make to protect themselves against cancer, but actually making those healthy choices remains difficult for many people,” said policy report panel member Shiriki Kumanyika, PhD, MPH, of the University of Pennsylvania School of Medicine. The policy report takes the next step – it identifies opportunities for us as a society to make those choices easier.

More information, including video interviews with panel members, Q and A documents, and other background materials, is available at: http://www.aicr.org/policy

Many popular diets emphasize either carbohydrate, protein or fat as the best way to lose weight.

Advocates of high protein diets claim that our Paleolithic ancestors obtained the majority of their calories from meat and thus our bodies have evolved to require a high protein intake. There is much scientific controversy over the relative importance of animal and plant foods in the early hominid diet. Direct evidence in the form of food remains is meagre or, at best, equivocal. Most research relies on inference through dietary studies of other primates and archaeological evidence. Most scientists now agree that plant foods contributed much more to the early hominid diet than did the flesh of animals.

Humans have adapted to their environments wherever they have settled and the balance between meat-eating and plant-eating varies substantially between populations. Some of the leanest and healthiest societies in the world, such as in the Mediterranean and Japan, consume a diet where the majority of energy comes from carbohydrates, mainly in the form of complex carbohydrates from whole grains and vegetables. This has led some researchers to propose that a high carbohydrate diet is better for maintenance of a healthy weight than a high protein diet.

Controversy about the role of fat in the diet has raged since the 1950s, when Ancel Keys published his landmark “Seven Countries” study and highlighted that coronary heart disease is strongly related to diet. Low-fat diets have therefore been promoted by governments and health professionals for several decades.

With the prevalence of obesity increasing at an alarming rate, everyone wants to know which of these dietary approaches – high protein, high carbohydrate, low fat – is the most successful for weight loss.

The scientific research conducted to date does not help much. Some trials have shown that low-carbohydrate, high-protein diets resulted in more weight loss over the course of 3 to 6 months than conventional high-carbohydrate, low-fat diets, but other trials have not shown this effect.

A smaller group of studies that extended the follow-up to 1 year did not show that low-carbohydrate, high-protein diets were superior to high-carbohydrate, low-fat diets. In contrast, other researchers found that a very-high-carbohydrate, very-low-fat vegetarian diet was superior to a conventional high-carbohydrate, low-fat diet. Among the few studies that extended beyond 1 year, one showed that a very-low-fat vegetarian diet was superior to a conventional low-fat diet, one showed that a low-fat diet was superior to a moderate-fat diet, two showed that a moderate-fat, Mediterranean-style diet was superior to a low-fat diet, one showed that a low-carbohydrate diet was superior to a low-fat diet, and another showed no difference between high-protein and low-protein diets.

Small samples, underrepresentation of men, limited generalizability, a lack of blinded ascertainment of the outcome, a lack of data on adherence to assigned diets, and a large loss to follow-up limit the interpretation of many weight-loss trials. The novelty of the diet, media attention, and the enthusiasm of the researchers may affect the adherence of participants to any type of diet.

There have been few studies lasting more than a year that evaluate the effect on weight loss of diets with different compositions of those nutrients. In a randomized clinical trial led by researchers at the Harvard School of Public Health (HSPH) and Pennington Biomedical Research Center of the Louisiana State University System, a comparison of overweight participants assigned to four different diets over a two-year period showed that reducing calories achieved weight loss regardless of which of the three nutrients was emphasized. The study, which was funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health, appears in the February 26, 2009 issue of The New England Journal of Medicine.

“This is important information for physicians, dieticians and adults, who should focus weight loss approaches on reducing calorie intake,” said Frank Sacks, professor of cardiovascular disease prevention at HSPH and lead author of the study.

The trial included 811 men and women who were randomly divided into four diet groups with different target nutrient compositions:

Low-fat, average protein: 20% of calories from fat, 15% of calories from protein, 65% of calories from carbohydrate

Low-fat, high-protein: 20% fat, 25% protein, 55% carbohydrate

High-fat, average protein: 40% fat, 15% protein, 45% carbohydrate

High-fat, high-protein: 40% fat, 25% protein, 35% carbohydrate

The participants were diverse in age, sex (62% women, 38% men), geography and income. The diets followed heart-healthy principles, replacing saturated with unsaturated fat and were high in whole cereal grains, fruits and vegetables. Each participant received a diet prescription that encouraged a 750-calorie reduction per day, however none were less than 1,200 total calories per day. Participants were asked to do 90 minutes of moderate exercise each week. They recorded their daily food and drink intake in a food diary and in a web-based program that provided information on how closely they were meeting their dieting goals. Individual counselling was provided every eight weeks over two years and group sessions were held three out of four weeks during the first six months and two out of four weeks from six months to two years.

The results showed that, regardless of diet, weight loss and reduction in waist circumference were similar. Participants lost an average of 13 pounds at six months and maintained a 9-pound loss at two years. Weight loss primarily took place in the first 6 months; after 12 months, all groups began to slowly regain weight, a finding consistent with other diet studies. However, the extent of weight regain was much less, about 20%, of the average regain in previous studies. Waistlines were reduced by an average of two inches at the end of the two-year period.

Most risk factors for cardiovascular disease improved for dieters at six months and two years. HDL (“good”) cholesterol increased and LDL (“bad”) cholesterol, triglycerides, blood pressure and insulin decreased. The metabolic syndrome, a group of coronary heart disease risk factors including high blood pressure, insulin resistance and abdominal obesity, also decreased.

The main finding from the trial was that diets with varying emphases on carbohydrate, fat and protein levels all achieved clinically meaningful weight loss and maintenance of weight loss over a two-year period.

“These results show that, as long as people follow a heart-healthy, reduced-calorie diet, there is more than one nutritional approach to achieving and maintaining a healthy weight,” said Elizabeth G. Nabel, M.D., Director, NHLBI.

Another important finding was that participants who regularly attended counselling sessions lost more weight than those who didn’t. Dieters who attended two thirds of sessions over two years lost about 22 pounds of weight as compared to the average weight loss of 9 pounds.

“These findings suggest that continued contact with participants to help them achieve their goals may be more important than the macronutrient composition of their diets,” said Sacks.

Have you spent years embarking on every weight-loss diet going? Have you tried cutting out entire food groups? Have you spent a fortune on miracle foods or diet powders? Have you eaten nothing except cabbage soup for weeks? Have you driven your friends mad with your fervour over food combining? Have you become obsessive about counting calories or points? Have you spent hours jumping on and off your bathroom scales? Do you feel hungry much of the time, exhausted and beset by cravings?

You can learn how to lose weight effortlessly without feeling hungry, whilst gaining health and vitality, at a Cooking for Health course on Managing Your Weight Naturally. We explore why so many diets fail and explode many of the weight loss myths. We look at cravings – how they arise and how to overcome them – and we discuss which foods the body needs to create energy and burn fat in the most efficient way. We create a delicious meal with an array of different dishes designed to illustrate how it is possible to eat plenty without gaining weight. The vital role of exercise in maintaining a healthy weight is also emphasised.

References

Strassman, B.I. and Dunbar, R.I. (1999). Human evolution and disease: putting the Stone Age in perspective. In Stearns, S.C. ed Evolution in Health and Disease, Oxford: Oxford University Press.

Lee, R.B. The !Kung San: Men, Women and Work in a Foraging Society. Cambridge University Press, 1979

A new analysis of data from the Nurses’ Health Study has shown that women whose diets most closely resemble a traditional Mediterranean diet are significantly less likely to develop heart disease and stroke [1].

Lead researcher Dr Teresa T Fung (Harvard School of Public Health, Boston, MA) commented that many other studies have looked at the effects of this diet on cardiovascular mortality, but this is one of few with enough participants to look at nonfatal events and also is the first to examine stroke as a separate outcome. Fung and colleagues report their findings online February 16, 2009 in Circulation.

“What this adds to the existing literature is that it shows a reduced risk of nonfatal events as well,” she notes. “My take on this is that all the data from different studies with different types of dietary patterns are pointing in the same kind of direction: a minimally processed, mostly plant-based diet, with an abundance–not just in terms of quantity but in terms of variety–of different plant foods and fish. I will single out fish because we included fish in our score. Oily fish seem to have a very strong relation in terms of being beneficial.”

29% Reduced Risk of MI, 13% Reduction in Stroke Risk

Fung and colleagues used data on 74 886 women who participated in the Nurses’ Health Study, and the current analysis averaged data from six different dietary assessments self-reported between 1984 and 2002. Previous studies have shown an association between the Mediterranean diet and a reduced risk of cardiovascular death in both men and women, they note.

They calculated the Alternate Mediterranean Diet (aMed) score, a measure constructed to assess US-based diets for their similarity to a traditional Mediterranean diet, for the women and divided them into quintiles. Relative risks for incident coronary heart disease, stroke, and combined fatal cardiovascular events were estimated and adjusted for cardiovascular risk factors.

During 20 years of follow-up, there were 2391 incident cases of CHD, 1763 incident cases of stroke, and 1077 cardiovascular disease deaths (fatal CHD and strokes combined).

Women in the top aMed quintile were at lower risk for both CHD and stroke compared with those in the bottom quintile (relative risk for CHD 0.71; p for trend <0.0001; relative risk for stroke 0.87; p for trend=0.03).

CVD mortality was also significantly lower among women in the top quintile of the aMed score (relative risk 0.61; p for trend <0.0001).

“These are dramatic results,” says Fung. “We found that women whose diets look like the Mediterranean diet are not only less likely to die from heart disease and stroke, but they are less likely to have those diseases.”

She stressed that these results–particularly the stroke finding–would need to be replicated in men, however.

An Easy-to-Follow Diet

Compared with a typical US diet, the Mediterranean-type diet requires a shift toward a more plant-based diet, which means eating less meat and getting more of the day’s protein from plant sources such as beans and nuts. It also emphasises unprocessed whole grains and unsaturated oils, such as olive oil.

The typical US dietary pattern of fast food and red meat high in saturated fats may be replacing the traditional Mediterranean diet even in Mediterranean countries. Greece, for example, has one of the highest prevalences of obesity in Europe. A recent study by researchers at the University of Michigan suggested a link between number of fast food restaurants in a neighbourhood and the risk of stroke.

You can learn how to cook delicious and heart-healthy food based on Mediterranean dietary principles at Cooking for Health courses, held throughout the year in Somerset, UK.

Ancient wisdom and modern science teach us that the quality of the food we eat is intrinsically linked with our level of health and well being.

The development of agriculture 10,000 years ago and the radical changes in the production and processing of food which have occurred in the last 200 years, have led to our diet moving further and further away from the natural foods which sustained our earliest ancestors 2.5 million years ago. From an evolutionary perspective, these changes have taken place too rapidly for the human genome to adjust. Biochemically and physiologically, we are virtually identical to the hunter-gatherers who roamed the earth 20,000 years ago[i],[ii].

There is growing scientific evidence that the evolutionary collision of our ancient genome with the nutritional qualities of recently introduced foods may underlie many of the chronic diseases of Western civilization, such as obesity, diabetes, heart disease and cancer[iii], as well as problems such as depression, mood swings, PMS, hot flushes, chronic fatigue, inability to cope with stress, allergies and susceptibility to illness and infection.

Today, a few societies in the world are noted for their healthy longevity, including Okinawans in Japan, Hunzans in Pakistan and Vilcabambans in Ecuador[iv]. Scientific studies have shown that these people consume a predominantly plant-based diet high in whole grains, locally grown vegetables, beans, fruits, nuts and seeds, with small amounts of animal foods, sea vegetables, natural sweeteners and condiments. In other words, natural, unprocessed foods similar to those consumed by the earliest human beings.

We too can be full of energy, in excellent physical health and with minds as sharp as razors into advanced old age if we move away from eating refined, processed foods and return to a more natural diet.

You can learn how to cook with these natural ingredients at Cooking For Health courses held throughout the year in Somerset, UK. The classes cover the basics of healthy eating and focus on different aspects of the link between nutrition and optimum health and well being. Topics include Managing Your Weight Naturally, Food and Emotions, Balancing Your Hormones, Beating Stress and Fatigue and Boosting Your Immune System.

The classes not only include cooking healthy and appetising recipes, but also slowly unfold a fascinating and comprehensive study of the healing power of food.

Whether you are young or old, male or female, vegan, vegetarian or omnivorous, a novice or an experienced cook, if you are seeking a natural approach to health and well being, you will find these classes valuable, interesting and potentially life-changing.

University of Liverpool scientists claim that the degeneration of sight, caused by a common eye disease, could be reduced by up to 20% by increasing the amount of fruit, vegetables and nuts in the diet.

Age-related Macular Degeneration (AMD) is the leading cause of blindness in the UK, with 45% of those registered as blind suffering from the disease. The condition results in a gradual loss of central vision, due to the failure of cells in the macular – the light sensitive membrane at the centre of the retina. There is currently no cure for the more common ‘dry’ form of the disease, which is suffered by 90% of AMD patients.

Professor Ian Grierson, Head of Ophthalmology at the University, has produced a comprehensive cooking guide called ‘Fruit for Vision’, designed to add fruit and vegetables into everyday meals (published by Indigo Creative Marketing and the Macular Disease Society). The recipes will help AMD sufferers slow down the degeneration process by increasing micronutrient, vitamin and antioxidant intake in the diet. Non-sufferers can also use the book to add fruit, nuts and vegetables into each meal to protect against the disease.

Professor Grierson said:

Poor eating habits have a huge impact on health in general and the health of your eyes is no exception. Eye problems such as AMD, cataract and even glaucoma can all be affected by what we eat. But a relatively minor change in diet – adding a little more fruit into our meals – can make a profound difference and can keep eye diseases like AMD at bay for up to 20% longer. There are of course other risk factors related to AMD such as age, light exposure, smoking and being overweight. But if we can improve the kind of food that we eat, we could dramatically reduce the number of people who may suffer from eye diseases in the future.

To learn how to incorporate more fruit and vegetables in your diet and create imaginative and mouthwatering recipes for all the family, come along to a Cooking for Health class, held throughout the year in Somerset, UK.

If you run a catering business, you can obtain valuable information and suggestions on how to increase fruit and vegetables in your menus at Healthier Catering courses, run by the nutrition expert, Jane Philpott, MA (Oxon), MSc, PhD.

Drinking at least three cups of green or black tea a day can significantly reduce the risk of stroke, a new University of California LA study has found. And the more you drink, the better your odds of staving off a stroke.

The study results, published in the online edition of Stroke: Journal of the American Heart Association, were presented on 19 February at the American Heart Association’s annual International Stroke Conference in San Diego, California.

The UCLA researchers conducted an evidence-based review of all human observational studies on stroke and tea consumption found in the PubMed and Web of Science archives. They found nine studies describing 4,378 strokes among nearly 195,000 individuals, according to lead author Lenore Arab, a professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA.

“What we saw was that there was a consistency of effect of appreciable magnitude,” said Arab, who is also a professor of biological chemistry. “By drinking three cups of tea a day, the risk of a stroke was reduced by 21 percent. It didn’t matter if it was green or black tea.”

And extrapolating from the data, the effect appears to be linear, Arab said. For instance, if one drinks three cups a day, the risk falls by 21 percent; follow that with another three cups and the risk drops another 21 percent.

This effect was found in tea made from the plant Camellia sinensis, not from herbal teas.

There are very few known ways to reduce the risk of stroke, Arab said. And developing medications for stroke victims is particularly challenging, given that the drug has to get to the stroke-damaged site quickly because damage occurs so fast. Arab said that by the time a stroke victim gets medical care, it’s nearly too late to impede the damage.

“That’s why these findings are so exciting,” she said. “If we can find a way to prevent the stroke, or prevent the damage, that is simple and not toxic, that would be a great advance.”

Though no one is certain which compounds in tea are responsible for this effect, researchers have speculated that the antioxidant epigallocatechin gallate (EGCG) or the amino acid theanine may be what helps. Antioxidants are believed to help prevent coronary artery disease.

“And we do know that theanine is nearly 100-percent absorbed,” Arab said. “It gets across the blood-brain barrier and it looks a lot like a molecule that’s very similar to glutamate, and glutamate release is associated with stroke.

“It could be that theanine and glutamate compete for the glutamate receptor in the brain,” she added.

Although a randomized clinical trial is needed to confirm this effect, the findings suggest that drinking three cups of green or black tea a day could help prevent an ischaemic stroke.

Whilst drinking a moderate amount of green and black tea clearly has benefits, excessive consumption can upset blood sugar regulation due to the relatively high caffeine content of the leaves of Camellia sinensis. If blood sugar is not well-regulated in the body, it can lead to symptoms of fatigue, cravings for sugar and a heightened stress response. If you like regular hot drinks throughout the day, why not try some herbal teas which also contain powerful antioxidants. Many people enjoy drinking Rooibos (or redbush) tea, made famous by the heroine of The No. 1 Ladies Detective Agency, Precious Ramotswe (Alexander McCall-Smith). Rooibos is naturally caffeine free and contains high levels of the antioxidants aspalathin and nothofagin. Aspalathin also has anti-mutagenic properties.

To learn more about green tea and herbal teas and their health benefits, why not come to a Cooking for Health course, held throughout the year in Somerset, UK.